So I just had a message to go on levo

[Burtonn]

Bout time 🙄😊Just had a text to go on levo 25mg as may help my heart rate but said I can still have the blood tests redone on 6th April hmm any advice what will happen to heart take them 👀 scary been getting lighted and palps will tablets make heart worse. can I take them with my none weight gain what can happen.

[SlowDragon Administrator]

How old are you

Unless over 65, standard starter dose levothyroxine is 50mcg

However having been left un treated a very long time, can be best to start on 25mcg

Have you got prescription yet?

Unless lactose intolerant, best to avoid Teva brand initially

Most easily tolerated and available in 25mcg tablets

Mercury Pharma or Wockhardt

Mercury Pharma make 25mcg, 50mcg and 100mcg tablets

Wockhardt only make 25mcg tablets

Suggest you wait until had bloods done on April 6th before starting

Or

Rebook bloods for 6-8 weeks after starting, as you will be ready for next dose increase in levothyroxine then

Meanwhile working on improving your very low vitamin levels at same time

Likely to need several further increases in levothyroxine over coming months. Unless extremely petite likely to need to be on at least 100mcg levothyroxine per day

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

Always test thyroid early morning, ideally before 9am and last dose levothyroxine 24 hours before test

[SlowDragon Administrator]

Check the brand, before leaving the pharmacy counter

If it’s Teva you can request different brand…..or try it and see how you get on

Some people vastly prefer Teva

[SlowDragon Administrator]

Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it many people find it more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

REMEMBER.....very important....stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results - eg vitamin B complex

[tattybogle]

yes , take them. Since you heart is very slow at the moment ,it IS probably a very good idea to start slowly by giving you just 25mcg for a short while. (You want your heart to get used to having more thyroid hormone gradually, so starting at half the usual dose is a good idea in your circumstances )

But ... 25mcg should be seen as just a temporary step for a few weeks at most, before getting to 50mcg which is the proper starting dose. Most of us will end up needing somewhere between 75mcg and 150mcg , but we have to get there gradually. testing bloods as we go along to find the exact right dose . and allowing at least 6 weeks on each dose before the blood test to see the effect.

Regarding your upcoming blood test on the 6th April:

you need to realise that taking 25mcg for 5 days before this blood test will probably lower your TSH a bit from wherever it is now ...and it will probably also raise your FT4 a bit from where it is now . Making it 'look' as though you are not as hypothyroid as you are now.

But this will NOT mean 25mcg is 'enough' . (or that you don't need it at all)

If your GP doesn't understand this, and if they are not good at understanding how to properly treat hypothyroidism , then they may see your results from the 6th and say "oh it's not that bad .. so you should stay on just 25mcg " and tell you to come back in a year.

If this happens . you will need to tell GP that you want to be re-tested once you have been on 25mcg for 6 weeks ., because testing after just 5 /6 days on a dose is far too soon to see the effect.

Do NOT let this GP leave you on just 25mcg and ignore you for a year, based on a blood test done after being on Levo for just a week.

What time of day is your blood test ? if it's in the morning Do NOT take that mornings dose of Levo until after the blood test .

Please come back and tell us how you get on this week ,and let us know what your GP says about the blood test results OK ? ( i'm not very confident your GP knows much about treating hypothyroidism from seeing all the daftness they have put you through so far !)

[tattybogle]

yes correct . have test >> THEN take that days levo dose afterwards.

[tattybogle in reply to tattybogle]

oh ... did you mean "should you wait till after test before you start taking any Levo at all ? "

[tattybogle]

You have a choice .. depends in which is most important to you . if you want to know and have evidence to prove how badly 'hypo' you are, then wait a few more days until the blood test and then start taking the Levo prescription afterwards . Once you are taking the Levo you won't ever be able to find out how high your TSH is now ... it may be useful to have evidence of this 2nd 'pre treatment ' blood test , just in case any body questions your diagnosis of hypothyroidism in future.

5 days of Levo might lower TSH a bit , but at just 25mcg /day it probably wouldn't lower it by much... but that's the thing with TSH ...nobody can predict how fast, or how much it will move.

On the other hand ... if your low heart rate is really concerning you, then forget about trying to prove how high your TSH is , and just start to take the Levo now .

They already have plenty of evidence that you have autoimmune hypothyroidism with TPOab's and TSH 6 then 7 ish ... and now a cardiologists opinion ... So if i was you i would start taking it now , and just deal with any blood tests questions that come up later.

[Burtonn in reply to tattybogle]

Thanks for reply I have and know something wasn't right about my heart rate last 6 years so think 7 days not bad to wait we see I make a decision also take few weeks to work meds